A short on importance of appropriate nutritional therapy in hospitalized patients

The appropriate nutrition of hospitalized patients has a direct effect on patient outcomes. Creating systems aimed at identifying patients at significant nutritional risk and monitoring adherence to evidenced based nutritional care practices have the potential to significantly improve outcomes and reduce costs. Patients who develop malnutrition represent a missed opportunity to deliver the critical nutrients needed and prevent the ramifications that come with a malnourished state. Despite increased calls for better nutritional screening, 1 in 3 patients who present to a hospital already meet the criteria for malnutrition. Malnutrition has significant clinical and economic ramifications. For example, surgical patients, who are just at risk for malnutrition, have a two-fold increased risk of post-operative complications, significantly longer length of stay (LOS), increased mortality, and higher costs.

Malnutrition is a major public health issue associated with substantial medical and economic implications. Hospitalized patients are at significant risk for malnutrition, with an estimated at risk prevalence ranging between 13-78%. Unfortunately, great controversy surrounds the formal definition of malnutrition, with multiple societies proposing contrasting definitions. Furthermore, this lack of a consistent objective measure for malnutrition leads to bias in diagnosis putting many patients at risk for misdiagnosis. This lack of an objective definition is likely because many nutritional parameters may be a mere reflection of the severity of patient illness rather than of nutritional status.

This also severely limits the direct comparison of nutritional studies. Malnutrition suffers from two sets of risk factors. Patient-specific risk factors include age and poor functional status, specific disease processes (cancer, alcoholism, gastrointestinal disease, and surgery), and treatments such as mechanical ventilation. In contrast, organizational factors are a major and preventable source of malnutrition risk. These factors include: failure to recognize malnutrition, lack of nutritional screening, lack of training, confusion regarding responsibility, and failure to record height and weight. Patient-specific risk factors are less likely to be modifiable, as the majority are present on admission or due to severity of disease. Quality improvement efforts should focus on reducing institutional barriers enabling the under diagnosis and under treatment of malnutrition.

The Journal Food and Clinical Nutrition  covers a broad spectrum of topics for study that discusses theoretical and conceptual aspects of Food and Clinical Nutrition like Nutrition and Food Sciences, Food Biotechnology, Nutrition, Clinical Nutrition, Obesity and Weightloss, Food Safety, Nutrition and Diabetes, etc.

Contact Details:
Aaron Province
Managing editor
Journal of Food and Clinical Nutrition
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